Provider Demographics
NPI:1548032550
Name:KERLOW, MARINA (LGMFT)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:KERLOW
Suffix:
Gender:F
Credentials:LGMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11865 FEDERAL SQ STE 106
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3226
Mailing Address - Country:US
Mailing Address - Phone:301-892-6811
Mailing Address - Fax:
Practice Address - Street 1:7000 CARROLL AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4437
Practice Address - Country:US
Practice Address - Phone:301-919-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM981106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist